Palliative care in the pre-hospital service in Brazil: experiences of health professionals

Background An integrated care network between emergency, specialized and primary care services can prevent repeated hospitalizations and the institutionalized death of terminally ill patients in palliative care (PC). To identify the perception of health professionals regarding the concept of PC and their care experiences with this type of patient in a pre-hospital care (PHC) service in Brazil. Methods Study with a qualitative approach, of interpretative nature, based on the perspective of Ricoeur’s Dialectical Hermeneutics. Results Three central themes emerged out of the professionals’ speeches: (1) unpreparedness of the team, (2) decision making, and (3) dysthanasia. Conclusions It is necessary to invest in professional training associated with PC in the home context and its principles, such as: affirming life and considering death as a normal process not rushing or postponing death; integrating the psychological and spiritual aspects of patient and family care, including grief counseling and improved quality of life, adopting a specific policy for PC that involves all levels of care, including PHC, and adopt a unified information system, as well as more effective procedures that favor the respect for the patients’ will, without generating dissatisfaction to the team and the family.

A Suggested Integrated Approach For The Evaluation Of Remote Intranet Usability

As the societal impacts of the Covid-19 progress, so do the workplace and business challenges the pandemic has brought on. It is now crucial to conduct user testing to measure and optimize the usability of corporate Intranets under pandemic conditions. This paper suggests and validates an integrated approach for Intranet remote usability evaluation validated by user testing in a work from home context during a pandemic. The main contribution of the current research is the discovery of some users preferences specific to work from home workers during a pandemic not previously addressed in the literature on intranets.

Are hedonia and eudaimonia higher on vacation than at home? Initial empirical evidence and a toolbox for future research

Vacations are assumed to be characterised by enjoyment. More specifically, the level of enjoyment on vacation is assumed to be substantially higher than that of a normal day at home. Yet, this assumption has never been empirically tested. This study provides initial empirical evidence for the fact that all enjoyment-related constructs at the core of positive psychology (hedonic trait and state motivation/orientation and experience, and eudaimonic trait and state motivation/orientation and experience) are significantly higher on vacation than in the normal, everyday home context. To arrive at these empirical findings, the study also introduces to tourism research a conceptual framework that unambiguously defines the most commonly used eudaimonic and hedonic constructs and develops and empirically assesses appropriate single-item measures.

Strategic Responses to Institutional Voids (Rationalization, Aggression, and Defensiveness): Institutional Complementarity and Why the Home Country Matters

We seek to understand how the strategic responses of firms to institutional voids are affected by their home countries’ institutional contexts. It adopts an exploratory, multiple case studies approach examining the responses of advanced and emerging multinational enterprises, and local firms in two African countries which are characterized by such voids, namely the Democratic Republic of the Congo and Zimbabwe. Our research suggests that firms’ strategic responses to institutional voids in emerging or developing markets are affected by the home country’s institutional environment and firms’ experiences and advantages arising from that home context. Firms adopt strategic responses which reflect their respective advantages and this results in diverse approaches based on the interplay between capitalizing upon internal resources and institutional know-how. For some firms this may result in a defensive strategic response, whilst for others opportunistic and aggressive agility, or rationalization and reconciliation may manifest. We demonstrate differences between advanced and emerging multinational enterprises and domestic firms covering the spectrum between institutional outsiders and insiders. We emphasize the contextual nature of these strategic responses and argue that this requires integrating both a resource and institution-based analysis of firms’ underlying advantages and how they are able to leverage off these advantages in institutionally voided environments. Practical implications arise for doing business in emerging and developing markets.

Regul-A: A Technological Application for Sensory Regulation of Children with Autism Spectrum Disorder in the Home Context

(1) Background: Sensory processing disorder is now recognised as a core feature of autism spectrum disorder that influences children’s adaptive behaviours, which, in turn, may interfere with their participation in life situations. This study describes the process of developing a technological platform, in the form of an app, to help families regulate children with ASD, aged 3–6 years old, by applying sensory strategies to improve the child’s participation in daily routines in the home context. (2) Methods: A focus group formed by four specialised occupational therapists who intervene with children with ASD was selected in order to understand and discuss content that should be included in the app. At a later stage, a group of three was involved to ensure quality and veracity in technological platform elaboration. (3) Results: The purpose of the app, named Regul-A, is to help parents regulate children with ASD regarding their participation in home routines. The sensory strategies provided by the focus group in the three major occupations of the child were the first results obtained, followed by the development of the app structure. (4) Conclusions: The next phase of the study will be the use of the platform by families of children with ASD and occupational therapists. It is believed that, in the future, Regul-A will be used as a tool to gather, analyse and manage data on the occupational performance of children with ASD in the home context, particularly for activities of daily living, sleep, rest and play, facilitating the implementation of strategies and the sharing of information between parents and occupational therapists.

Musical achievement during a lockdown: The parental support miracle

The quality of parental support is recognized as a crucial factor in the early stages of a student’s development, and particularly in instrumental music education. At the start of 2020, the outbreak of a global pandemic crisis posed new and unprecedented challenges to education, forcing families to stay at home to prevent contagion. This investigation was conducted during the period of a COVID pandemic lockdown in Portugal. We explored whether parental support, provided during the lockdown period, was associated with their child’s achievement as reported by their instrumental music teacher. For this study, 39 parent–teacher dyads of first-grade students of an instrument music course were recruited from two public music conservatories. Parents supplied information on the frequency in which they provided student-support-related attitudes and actions in the home context. Simultaneously, teachers provided information about the student’s achievement during the lockdown compared with the previous in-person performance period. Results indicate a strong relationship between parental support and musical achievement, with students who received higher levels of supportive parental involvement performing better than before the pandemic crisis. The findings are discussed in relation to the importance of parental involvement in a child’s instrumental music education.

Supporting Ethical Decision Making – A Tool for Ethical Reflection on Care Technologies

"The tool FreTiP (Fragen zur ethischen Reflexion von digitalen Technologien in der Pflegepraxis – questions on ethical reflection of digital technologies in nursing practice) was developed in 2020 by the Institute Mensch, Ethik und Wissenschaft (IMEW) as part of ELSI research in the PPZ-Berlin project. Our aim was to develop an instrument that stimulates and supports ethical reflection processes in the application of digital care innovation technologies in practice. Ethical considerations are part of everyday (nursing) life, are closely interwoven with other aspects and are therefore difficult to recognise as such. The starting thesis of our work was that actors in care act on the basis of value concepts that they are more or less aware of. An ethics that is consciously integrated into everyday care takes into account all aspects that are relevant for an action or decision. In this respect, it is important to look at ethics in context and not to understand “ethics” as something isolated, coming from outside. Based on this, the development of the instrument should not consist of “breaking down” ethical concepts and theories to practice, but of ethically locating, structuring and making applicable the experiences, questions and needs of the actors working in nursing practice. Thus, FreTiP is not only to be considered practice-oriented, but also to a certain extent practice-based. The instrument was designed to be suitable for everyday care in clinics, care facilities and in the home context. FreTiP was developed as a low-threshold instrument that can be used flexibly and that takes into account the perspective of patients as well as carers. The development of the instrument was preceded by a triangulated study that included a literature review, interviews and (non-)participatory observations. In the paper, experiences with the ethical reflection tool FreTiP will be presented. "

Meaning in Life for Patients With Severe Dementia: A Qualitative Study of Healthcare Professionals' Interpretations

The need for meaning in life is a key aspect of being human, and a central issue in the psychology of religion. Understanding experience of meaning for persons with severe dementia is challenging due to the impairments associated with the illness. Despite these challenges, this article argues that meaning in life is as important for a person with severe dementia as it is for everyone else. This study was conducted in a Norwegian hospital and nursing home context and was part of a research project on meaning in life for persons with severe dementia. The study builds on two other studies which focused on how meaning-making and experience of meaningfulness appeared in patients with severe dementia. By presenting the findings from these two studies for a group of healthcare professionals and introducing them to research on meaning in life, the aim of this study was to explore how healthcare professionals interpret the patients' experience of meaning in life in practise for patients with severe dementia in a hospital and nursing home context, and to highlight its clinical implications. The study was conducted using a qualitative method with exploratory design. The data were collected at a round table conference, a method inspired by a mode of action research called “co-operative inquiry.” Altogether 27 professional healthcarers, from a variety of professions, with high competence in dementia care participated together with six researchers authoring this article. This study revealed that healthcare professionals were constantly dealing with different forms of meaning in their everyday care for people with dementia. The findings also showed clear connexions between understanding of meaning and fundamental aspects of good dementia care. Meaning corresponded well with the principles of person-centred care, and this compatibility allowed the healthcare professionals to associate meaning in life as a perspective into their work without having much prior knowledge or being familiar with the use of this perspective. The study points out that awareness of meaning in life as an integrated perspective in clinical practise will contribute to a broader and enhanced repertoire, and hence to improved dementia care. Facilitating experience of meaning calls for increased resources in personnel and competence in future dementia care.

Near Peers Impacting Local Thai Tutors’ Intercultural Communication Competence Development

Most study-abroad research has focused on visitors’ development overseas; however, fewer studies have investigated hosts’ development through intergroup contact experience in home environments. This study, which is situated within a larger project, builds on earlier research (see Deacon & Pholboon, 2020) that examined the intercultural communication competence (ICC) development of 8 local Thai tutor hosts (N = 8) who were buddy partnered with 8 Japanese university student visitors during a short-term study-abroad program. In the present study, a qualitative semi-structured interview approach helped to determine the effect and influence that one significant factor, near-peer role models (NPRMs), had on tutor hosts’ cognitive, affective, and behavioral dimensions in their “Internationalization-at-Home” context. Findings revealed the perceived impact that previous senpai tutor NPRMs had had on present tutors’ L2 self-efficacy, imagined and actual cross-cultural friendships, and ICC ability. Implications for effectively supporting hosts’ ICC development in local environments are offered. 従来の留学研究は、訪問者側の成長に焦点を合わせることが多かったが、自国環境における異種集団との接触を通じた受入側の成長を調査する研究は少なかった。本論は、短期留学中の8人の日本人大学生とバディを組んだ受入側8人のタイ人チューター(N=8)を対象とした異文化コミュニケーション能力に関する先行研究(Deacon & Pholboon, 2020) に基づいている。本論は質的な半構造化面接により、身近なロールモデルの存在が 重要な要素として受入側 チューターの「内なる国際化」における認知的、情緒的、行動的な側面に影響を及ぼすことを明らかにした。結果として、過去の先輩チューターのロールモデルが、現チューターの第二言語における自己効力感や、想像上または実際の異文化を超えた友情、そして異文化コミュニケーション能力に影響をもたらすことがわかった。本論は、受入側の異文化コミュニケーション能力の向上を効果的に支援するための示唆を与えるものである。

Family Role in the Development of Self-Determination for Youth With Intellectual and Developmental Disabilities: A Scoping Review

The development of self-determination is promoted by supportive contexts during adolescence; families are a key part of this context. In adolescent populations, research suggests families can support self-determination in a number of ways, yet less is known about how self-determination is promoted within families of youth with intellectual and developmental disabilities (IDD). To address this knowledge gap, we conducted a scoping review to examine the existing evidence pertaining to the role families of youth with IDD play in supporting the development of self-determination. A review of 24 publications revealed that existing research has focused on understanding family perspectives on self-determination, but there is a lack of studies investigating how families provide supports for self-determination in the home context for youth with IDD. Additionally, little intervention work has focused on supporting families to promote self-determination. Based on the findings, implications for future research and practice are provided.